Older Adults

Paying for Private Duty Nursing

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Types of Insurances
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Private Duty Nursing

Providers of Private Duty Nursing services submit claims to insurance companies first if the service is a covered benefit. They will send you statements about the billings. Contact your insurance provider for specific coverage information, including criteria, deductibles, and copays.

It is very important that insurance coverage is established before contacting or contracting with any private duty providers to avoid a potentially large bill for a patient. Private Duty Nursing providers review insurance coverage prior to initiating services.

Commercial Insurance
In most cases, Private Duty Nursing services are not covered by insurance. Some insurance plans will cover private duty services when there is an established "Medical Necessity."

Managed Care Insurance
Managed care insurance companies identify their "network" health systems, and you may have to select a Private Duty Nursing provider within that network to receive coverage. Contact your managed care insurance provider to discuss how your private duty nursing provider selection may impact reimbursement.

Medicare
Medicare does not cover Private Duty Nursing services.

Medical Assistance
Medical Assistance does have provisions for Private Duty Nursing. Contact their representatives to learn more about when these services would be covered.

U.S. Veteran's Benefits
U.S. Veteran's Benefits may have provisions for Private Duty Nursing. Contact their representatives to discuss this benefit.

Your Out-Of-Pocket Costs
Typically, patients must pay for all Private Duty Nursing care nursing expenses.

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